Lyme's Disease

So called after Lyme in Connecticut USA where the disease was first identified and originally described.

Lyme's is a multisystem disorder caused by the spirochete Borrelia burgdorferi that is a common tick borne infection in the USA. Currently, it is not believed to be here in the U.K., however its incidence is on the increase. It is known to be endemic in New England, Long Island and the Pacific North West.

It occurs most often in spring and summer when - in the USA - the deer tick vectors are the most active. Prompt removal of the tick from the skin before they become attached or gain access to the bloodstream - in the first 24 to 48 hours - decreases the risk of transmission. However, it is often the case that the original bite is undetected and unremembered.

It is diagnosed by the presence of a rash called erythema chronicum migrans, which begins as a red ring at the site of the tick bite and expands to leave a clear centre.

In prophylactic terms, the best approach is to avoid being bitten when out in areas known to be infested with ticks. In the U.K. it is currently unknown where the reservoir of infection resides. It is therefore sensible to ensure that you cover up when going into the wild - tuck trousers into your socks and when you return home ensure that your clothes are properly handled and washed to prevent infection. Particular care of your dog and cat is sensible. The wearing of an insect repellents that include DEET will help to avoid being bitten. you should also carry out a visual inspection to see if any ticks or nymphs are on the skin and should be removed with tweezers and the area cleaned with alcohol.

Lyme's and its 3 stages

Stage One

This stage begins with a localised infection around the original tick bite. After an incubation period of 7 to 14 days, patients might develop erythema chronicum migrans at the site of the bite, develop headaches, stiff neck as well as muscle and joint pain.

Note that the tick may be so small that the original bite is not remembered.

Stage Two

In this stage the infection is disseminated throughout the body as the spirochetes are distributed by the blood stream to various parts of the body. This stage lasts from weeks to months and is accompanied by - in some cases - arthritic pains typically in the knees, muscle pain, cardiac dysrhythmias, pericarditis, lymphadenopathy, or meningoencephalitis.

During this stage, antibodies are produced by the body, however they are unable to provide any protection.

Stage Three

This stage is characterised by chronic infection. It usually occurs 2 to 3 years after the original bite. Patients develop either mild to severe arthritis or encephalitis or indeed both. The condition is rarely fatal.

The Treatment of Lyme's

The problem here in the U.K. is that Lyme's is not recognised as being a problem so it is difficult to persuade your G.P. to ask for a blood test for Lyme's. It is possible to get your blood tested abroad which will help you when dealing with your G.P.

The standard treatment for Lyme's is a long oral course of antibiotics - either ampicillin or doxycycline. For those who are allergic to penicillin, the alternative is Erythromycin or cefuroxime. This is normally a course for 3 to 4 weeks. As there are often cardiac and neurological issues with Lyme's, a patient is often treated with ceftriaxone or cefotaxime for 4 weeks or more.

A Vaccination for Lyme's

A vaccine exist for Lyme's but is not recommended for children, pregnant women and for general use, unless the person is going to be exposed to an environment when Lyme's in endemic. Therefore it is not considered to be safe vaccine.